Heart:中高危房颤患者的直接口服抗凝治疗与死亡率

2019-04-13 xiangting MedSci原创

在这个新诊断的NVAF患者队列中,与无口服抗凝治疗相比,DOAC治疗与死亡风险显著降低相关。

虽然直接口服抗凝药(DOAC)是非瓣膜性房颤(NVAF)患者的推荐抗血栓疗法,但NVAF患者的抗凝治疗仍存在不足。不使用DOAC治疗对患者生存率的影响尚不清楚。因此,这项研究目标是比较接受DOAC治疗的NVAF患者与不接受抗凝治疗类似患者的全因死亡率。

这是一项回顾性队列研究,研究人员分析了Clalit 医疗服务广义电子数据库,该数据库涵盖了2011年1月1日至2016年12月31日可以接受DOAC治疗的所有新诊断并未经抗凝治疗的NVAF患者。接受DOAC治疗的患者根据倾向评分与未接受抗凝治疗的患者进行匹配。主要结局是全因死亡率。最终的患者随访日期为2017年5月15日。

共确定了18901名符合条件的患者。8298名接受DOAC治疗,10603名未接受抗凝治疗。其中,5657名接受DOAC治疗的患者与5657名未接受抗凝治疗的患者进行匹配。DOAC治疗组715名患者死亡(每年7.6%),非抗凝组中2075名患者死亡(每年11.1%)。DOAC治疗与全因死亡率的风险显著降低相关(HR=0.69,95%CI 0.63-0.75,p<0.001)。所有分析的亚组都证实了DOAC治疗的益处。

在这个新诊断的NVAF患者队列中,与无口服抗凝治疗相比,DOAC治疗与死亡风险显著降低相关。这项研究结果进一步证明了NVAF患者接受DOAC抗凝治疗的重要性。

原始出处:

Ronen Arbel. Direct oral anticoagulation and mortality in moderate to high-risk atrial fibrillation. Heart. 10 April 2019.

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    2019-04-15 zhaojie88
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    2019-04-15 slcumt
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